ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to investigate whether a more coordinated, comprehensive head injury rehabilitation program provided at a children’s trauma center yielded better outcomes than a less coordinated, less comprehensive program.DesignUsing a quasi-experimental design, 64 children with head injury admitted to the center and who received rehabilitation services in either 1995 or 1993 were evaluated by using the Functional Independence Measure for children (WeeFIM™)/The Functional Independence Measure (FIM™) (e.g., primary outcome measure). Secondary outcomes included “psychosocial adjustment,” “return to regular school,” and “current problems related to the head injury.”ResultsNo statistically significant differences were found between the groups with respect to mean WeeFIM/FIM scores after controlling for age and injury severity. The 1993 group had poorer scores on the withdrawal subscale of the psychosocial measure (P= 0.02), yet a smaller proportion of these children were enrolled in a special education class (P= 0.02).ConclusionsThis study serves as a model for a larger, definitive study of the effectiveness of rehabilitation for children with head injury. The trends suggest that more comprehensive care may lead to better outcomes.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveContinuous passive motion (CPM) has been shown to increase significantly the amount of knee flexion for patients with total knee arthroplasty in the acute care hospital. Whether there is any additional benefit to using CPM for these patients who are transferred to a rehabilitation hospital is not known. There have been no prospective, randomized, controlled studies in this area.DesignFifty-one such patients on an inpatient rehabilitation service were randomly assigned to two groups. Group 1 (n= 23) received CPM for 5 consecutive hours per day plus physical therapy, whereas group 2 (n= 28) received only physical therapy. Knee flexion was measured by a blinded physical therapist on admission, on the third and seventh days of hospitalization, and at the time of discharge.ResultsThe results indicated no significant difference in passive range of motion between group 1 and group 2. Patients in group 1 achieved an average increase in passive range of motion of 16 degrees, whereas those in group 2 achieved an average of 19 degrees (P= 0.33).ConclusionAlthough power analysis indicated the need for differences in results for 32 patients per group to achieve significance, the difference between the two groups suggested neither statistical nor clinical significance. We concluded that the use of CPM in the rehabilitation hospital is likely of no added benefit to patients admitted after single total-knee replacement.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to compare the responses of multiple sclerosis (MS) patients to short-term cooling therapy using three different vest configurations.DesignEach garment was used to cool 13 male and 13 female MS subjects (31–67 yr). Oral and right and left ear temperatures were logged manually every 5 min. Arm, leg, chest, and rectal temperatures, heart rate, and respiration were recorded continuously on a Biolog ambulatory monitor. Each subject was given a series of subjective and objective evaluation tests before and after cooling.ResultsThe Life Enhancement Technologies and Steele vests test groups had similar, significant (P< 0.01) cooling effects on oral and ear canal temperatures, which decreased approximately 0.4°C and 0.3°C, respectively. The Life Enhancement Technologies active liquid cooling vest produced the coldest (P< 0.01) skin temperature and provided the most improvement on subjective and objective performance measures.ConclusionsThese results show that the various garment configurations tested do not produce similar thermal responses in all MS patients. The circulating liquid cooling vest was found to be more effective than either of the two passive cooling garments tested.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo determine whether thyrotropin-releasing hormone (TRH) can increase muscle strength in children with spinal muscular atrophy types 2 and 3.DesignA randomized, double-blinded, controlled, 5-wk drug trial of six subjects and three controls. Subjects and controls ranged from 4 to 8 yr of age and were randomly assigned to treatment and placebo groups in a ratio of 2:1. TRH (protirelin) or placebo was delivered intravenously through percutaneous intravenous catheters at a dose of 0.1 mg/kg (in 50 ml of normal saline) for a total of 29 days. Patients were evaluated using electromyography and handheld dynamometry of the deltoids, biceps, triceps, wrist extensors, hip flexors, quadriceps, hamstrings, and grip strength before and immediately after 5 wk of treatment. A unidirectionalttest was used to compare mean values.ResultsDynamometry improved significantly only for the six treated subjects (P< 0.02). Peroneal nerve conduction velocities were significantly faster in the treatment group (pairedttest,P= 0.036). The parents of the treated children also provided anecdotal evidence of improvements in function. Improvements lasted 6–12 mo.ConclusionsTRH may be a useful treatment for spinal muscular atrophy. A larger, crossover design group comparison study is warranted.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

ObjectiveTo apply motor control assessment for selection of appropriate spastic cerebral palsy children to receive selective posterior rhizotomy (SPR).DesignForty children with spastic cerebral palsy (3–16 yr) were divided into three groups: “independent ambulator,” “dependent ambulator,” and “nonambulator.” Another 18 healthy children were selected as the control group. Both motor control (tested by using polyelectromyography (PEMG)) and clinical ambulatory capability were assessed within 1 mo before SPR and 12 mo after.PEMG patterns were classified into seven patterns according to electromyographic activities during hip/knee flexion and extension. Gait patterns, which were analyzed by computer DynoGraphy, were classified into four patterns for children with ambulatory capability.ResultsPEMG and gait patterns were correlated with ambulatory ability. PEMG patterns 2–3 could predict independent ambulatory ability, whereas patterns 6–7 will interfere with ambulatory ability. PEMG patterns showed significant improvement after SPR in the ambulatory groups (P< 0.05), whereas they did not improve in the nonambulator group. Children with cerebral palsy with co-contraction of proximal/distal muscles had better results after SPR, whereas those with diffuse co-contraction or reduced electromyography activities had poor results.ConclusionsPEMG patterns may allow the physician to select the appropriate children with spastic cerebral palsy to receive SPR with good results.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

We report a case of a patient with Duchenne muscular dystrophy who was treated with intermittent pulse prednisone for severe asthma from age 3 to 17 yr and had remarkable preservation of skeletal muscle function. He had a maternal uncle with Duchenne muscular dystrophy who had the identical familial deletion mutation and died at age 19 of respiratory failure. Compared with his untreated uncle, our patient remains partially ambulatory at age 20. This case provides interesting, albeit anecdotal, evidence of considerable clinical benefit from pulse prednisone used on a much longer term basis than has been previously studied and promotes the need for further investigation on this type of therapy in Duchenne muscular dystrophy.

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:2000

数据来源: OVID